How is lumbar disc herniation formed: etiology and pathology of lumbar disc herniation
The cause of disease
Lumbar disc herniation The lumbar spine is the most active part in people's daily work and life, bearing the gravity from the upper limbs and trunk, and it is most prone to strain and trauma, and the intervertebral disc of the lumbar spine is also the most fragile. It is generally believed that lumbar disc herniation occurs on the basis of disc degeneration, and trauma is an important cause.
(1) Physiological degeneration factors of lumbar intervertebral disc: Normal intervertebral disc is elastic and tough, and has strong compression resistance. However, with the increase of age, intervertebral disc tissue is prone to degeneration, which is the process of aging. It is generally believed that after the age of 20, the intervertebral disc begins to degenerate, the water content of the nucleus pulposus gradually decreases, and the elasticity and load resistance of the intervertebral disc also decrease. Among them, fibrous ring, cartilage endplate and nucleus pulposus are all pathological degeneration.
(2) Traumatic factors: When the intervertebral disc degenerates or the annulus fibrosus has cracks, trauma is the main reason for the rupture of the annulus fibrosus. If the lumbar intervertebral disc is suddenly squeezed or twisted, resulting in an increase in the pressure of the nucleus pulposus, the nucleus pulposus can protrude into the spinal canal from the fissure of the annulus fibrosus.
pathology
The pathological changes of lumbar disc herniation can be roughly divided into three stages:
1, pre-protrusion: the nucleus pulposus can become fragments or scar-like connective tissue due to degeneration and injury; Denatured fiber rings will become thinner and softer, or cracks will occur due to repeated injuries. At this stage, the patient may have waist discomfort or pain, but there is no radiation pain in the lower limbs. Some people have no pathological changes, but a big violence can cause nucleus pulposus protrusion.
2. Protrusion period: When the pressure of intervertebral disc increases due to trauma or normal activity, the nucleus pulposus protrudes from the weak point or rupture of the annulus fibrosus. When the protrusion stimulates or compresses the nerve root, or compresses the cauda equina nerve to cause dysfunction of urination and defecation, radiation lower limb pain occurs. Because of disc degeneration in elderly patients, the whole fibrous ring becomes weak and relaxed, and the disc may spread to the periphery.
3. Late stage of protrusion: After lumbar disc protrusion, if the course of disease is long, various secondary lesions can occur in the disc itself and other adjacent structures.
According to pathological changes, CT and MRI manifestations, combined with treatment methods, the following types can be made.
1. Heavy type
The fiber ring is partially broken, but the surface layer is still intact. At this time, the nucleus pulposus swelled into the spinal canal due to compression, but the surface was smooth. Most of this type can be alleviated or cured by conservative treatment.
2. Protrusive type
The fibrous ring is completely broken, and the nucleus pulposus protrudes into the spinal canal, only covered by the posterior longitudinal ligament or a layer of fibrous membrane, and the surface is uneven or cauliflower-like, which often requires surgical treatment.
3. No prolapse type
Ruptured and protruding intervertebral disc tissue or fragments are separated from the spinal canal or completely free. This type can not only cause nerve root symptoms, but also easily cause cauda equina symptoms, and non-surgical treatment is often ineffective.
4. Nodules of Schmohl
The nucleus pulposus enters the cancellous bone of the vertebral body through the cracks in the cartilage of the upper and lower endplate. Generally, there is only low back pain, no nerve root symptoms, and most of them do not need surgical treatment.
Treatment of lumbar disc herniation
Plaster therapy
The plaster has a high consistency, so it has the advantages of high content of active ingredients, slow precipitation speed, lasting effect and practical local curative effect. Moreover, Zhao's health care lumbar patch has a series of advantages such as no pain, no complications, safety and convenience, and definite curative effect, and has long been the first choice for many patients.
Chinese traditional treatment
The disease belongs to the category of traditional Chinese medicine? Low back pain? Low back and leg pain? 、? Joint pain? Category. Traditional Chinese medicine uses drug therapy for treatment. Clinically, Jiawei Jingyaokang Capsule is a pure Chinese medicine preparation with special effects, and its main components include Semen Strychni preparata, Lycopodium, Cortex Periplocae, Olibanum (processed with vinegar), Myrrha (processed with vinegar), Carthami Flos, Lumbricus, Rhizoma Drynariae (processed), Radix Stephaniae Tetrandrae and Achyranthis Radix. Semen Strychni in the prescription tastes bitter and cold, and has strong functions of dredging collaterals, penetrating joints, dispelling cold and removing dampness, reducing swelling and relieving pain, and has a peculiar curative effect on rheumatism with deep pathogenic wind, cold and dampness and severe pain. Frankincense and myrrh are pungent in dispersing bitterness and cooling, fragrant in dispersing stagnation, soothing the interior and dredging the internal organs, dredging the collaterals from the exterior to the interior, promoting blood circulation and relieving pain, reducing swelling and promoting granulation, and have a unique miraculous effect on obstinacy, qi stagnation and blood stasis and eliminating pathological congestion and edema; The combination of various drugs has the effects of relaxing muscles and tendons, dredging collaterals, promoting blood circulation, removing blood stasis, reducing swelling and relieving pain.
Traditional Chinese medicine believes that the key to the occurrence of lumbar disc herniation is deficiency of kidney qi and dystrophy of bone and muscle. The inducement is the evil of falling down or cold and dampness. The pathogenesis of low back pain is that the meridians are blocked and the qi and blood flow is not smooth. Traditional Chinese medicine is a part of traditional medicine. It is profound and has a long history. This is the quintessence of China. For thousands of years, I don't know how many incurable diseases have been cured, which has always been the pride of China people. What is the traditional theory of treating lumbar disc herniation? Wind-cold-dampness evil, meridian impassability, leading to meridian impassability, which leads to pain? Therefore, the external application of traditional Chinese medicine lumbar bone prescription Shiyi ointment aims at expelling wind and cold, relieving spasm and dredging collaterals, promoting blood circulation and removing blood stasis. Following the painless principle of the general principles of traditional Chinese medicine, the curative effect is thorough, and it can achieve the functions of dredging meridians, reducing swelling and relieving pain, thus treating lumbar disc herniation.
general treatment
Lumbar disc herniation is one of the common lumbar diseases in clinic, and it is also a common and frequently-occurring disease in orthopedics. It is mainly because all parts of lumbar intervertebral disc (nucleus pulposus, annulus fibrosus and cartilage plate), especially nucleus pulposus, have different degrees of degenerative changes. Under the action of external factors, the annulus fibrosus of intervertebral disc ruptures, and the nucleus pulposus tissue protrudes (or protrudes) to the back or spinal canal, resulting in adjacent tissues, such as spinal nerve roots. The most common symptom of patients with lumbar disc herniation is pain, which can be manifested as low back pain and sciatica. Typical sciatica is radiation pain from hip, posterior thigh and lateral calf to heel or instep. According to clinical statistics, about 95% of patients with lumbar disc herniation have different degrees of low back pain, and 80% have lower limb pain. Especially low back pain is not only the most common symptom of lumbar disc herniation, but also one of the earliest symptoms. Therefore, if you find a similar situation, you should see a doctor in time, make a clear diagnosis, rule out the possibility of other factors, and check carefully to avoid missed diagnosis and delay the illness. Some patients blindly treat without correct diagnosis and lose the best treatment opportunity.
Timely, regular and effective treatment of lumbar disc herniation after diagnosis is very important. There are many clinical methods to treat lumbar disc herniation, including physical therapy, drug therapy, traction and massage. It can play a role, but the key to the treatment of lumbar disc herniation lies in persistence. Among the above methods, physical therapy is the most commonly used and the easiest to adhere to, and Jin Zhukang belt is the most common one, which has the functions of hyperthermia, magnetic therapy and traction fixation. Insisting on using it can achieve the functions of dredging meridians, diminishing inflammation and relieving pain, promoting effective blood circulation of lumbar muscles and exchanging oxygen saturation, and really play a role in strengthening lumbar muscles and restoring lumbar protection of lumbar muscles and surrounding ligaments. So as to effectively treat diseases.
In addition, functional exercise and daily rehabilitation are also very important. In the process of treatment and subsequent rehabilitation treatment, we should combine correct labor posture with work and rest. Prevent the waist from being stimulated by bad factors such as cold. Strengthening muscles, exercising strong back muscles and balancing the strength of spine can prevent back soft tissue injury and reduce the occurrence of lumbar disc herniation. Jin Zhukang's physical therapy and functional exercise at the same time can avoid the complications after recovery, and with correct functional activities, it can accelerate the absorption of stagnant water. Health care after rehabilitation is very important. To achieve the above aspects, lumbar disc herniation can be completely cured.
Multifunctional therapy
Early lumbar disc herniation, mild symptoms, no need for special treatment.
First, pay attention to bed rest, to avoid external pressure on the lumbar spine.
Second, use other methods to actively exercise the strength of lumbar muscles, increase the strength of lumbar anterior ligament, posterior ligament and lateral ligament, and avoid the compression of intervertebral discs from breaking through the protection of normal ligaments and muscles of human body. Strengthening lumbar muscle exercise can prevent and delay the occurrence and development of cervical spondylosis and treat early lumbar disc herniation. According to the survey, the probability that lumbar disc herniation will continue to attack and develop has dropped by 80% in people with developed lumbar muscle ligaments and great strength. Therefore, the intense exercise of ligaments and muscles around the waist is of great significance to the treatment and recovery of lumbar disc herniation. In this regard, it is suggested that patients with lumbar disc herniation should pay more attention to some commonly used medical devices in China, such as low back pain treatment belts, during daily family treatment. , is a common method of multifunctional treatment in China. The therapeutic belt for low back pain belongs to medical equipment products, and the product design structure has four functions: magnetic therapy, hot steaming, traction and fixation.
(1) For low back pain caused by sprain, sedentary, cold and other reasons, magnetic therapy can improve microcirculation and tissue metabolism, promote blood circulation, and achieve the purpose of relieving pain. For low back pain caused by lumbar inflammation and degenerative changes, magnetic therapy can improve the activity of hydrolase, hydrolyze or transform bradykinin, histamine, 5- hydroxytryptamine and other pain-causing substances, and achieve the effect of relieving pain. Used for lumbago due to kidney deficiency, involving lumbago, etc. The magnetic field acts on the human body, and the bioelectric magnetic energy is enhanced through the meridians and acupoints, which can promote the circulation of qi and blood in the meridians, dredge the meridians, and achieve the effect of dredging collaterals and relieving pain.
(2) The unique design of the dermal thickening airtight belt ensures that the covered affected part maintains a high skin temperature and humidity, and produces its own hot steaming physiotherapy effect, which is conducive to increasing local blood circulation.
(3) The inner layer of the big pillow belt is attached with steel plates to support the curvature, emphasizing the advantages of traction and fixation, which can effectively support the spine and lumbar vertebrae, enhance the contraction force of lumbar muscles, and better treat low back pain caused by diseases such as lumbar disc herniation, ankylosing spondylitis, lumbar hyperosteogeny, lumbar hypertrophy and spinal stenosis.
(4) It is very convenient to use, and the strap can be adjusted according to one's body shape or comfort. No matter walking, exercising, working at a desk or staying in bed, it will not affect the treatment. Therefore, considering comprehensively, adopting symptomatic methods and paying attention to persistent treatment, lumbar disc herniation can be completely cured. Disc herniation is caused by bad living habits and working habits, and bad sitting posture, standing posture, bending over for a long time or heavy physical labor are all reasons. When the prominent intervertebral disc compresses the nerve, there will be symptoms such as numbness, abdominal distension, weakness of limbs and pain. Relieving the compression of nerve caused by protrusion is the basis of treatment. Which treatment scheme is adopted depends on the different pathological stages and clinical manifestations of the disease.